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Contact lens orders

If you are a current patient in our practice and you need more contact lenses, please use this form to place your order.

No need to know your prescription details!  We have all that covered for you.


We need payment in full before we can ship lenses to you. A staff member will call you for a credit card number, or you can stop in and pay at the office.  Do not include card information on this form.

We'll call you when they arrive at the office (usually the next business day).

Shipping Information

•All orders will be shipped to the office unless you request otherwise. 

•If you would like the contacts shipped directly to you, a $7.95 shipping charge will be applied-- or purchase a whole year's supply of lenses, and we will ship them to you for free. 

Order Details

Thanks for submitting!

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